Iodine-131 (I131) emits beta and gamma radiation and is used, in the form of sodium iodide, to treat thyrotoxicosis and thyroid cancer. When dealing with a patient recently treated with I131, it is necessary to take some simple radiation protection precautions. The patient will have been given an information sheet with details of when the treatment was administered.
This sheet also includes a date until which they must show the information sheet to healthcare professionals dealing with them.

Patients treated with I131 less than 17 days ago

If the patient is admitted to hospital within 17 days of receiving I131 it is necessary to establish a radiation controlled area around the patient’s bed and follow some simple precautions.

For patients admitted to Hull University Teaching Hospitals NHS Trust, details of the precautions are contained in the “Local Rules” which can be found on the Trust Intranet (Pattie).
These also contain contact details for local staff who can offer advice.

For patients admitted to Northern Lincolnshire and Goole NHS Foundation Trust, details of the precautions are contained in the “Local Rules” which can be found on the Trust Hub.

For patients admitted to other hospitals, contact your own hospital’s Radiation Protection Adviser. Until advice is obtained, follow the general precautions given below:

  • I131 is likely to be present in the bodily fluids of the patient, therefore it is important to avoid contamination with or ingestion of bodily fluids. Good hygiene practices, including wearing gloves and aprons, will be sufficient to prevent ingestion in most situations.
  • Wash hands with soap and water after patient contact rather than using a hand-sanitiser.
  • If dealing with body fluids or faeces and there is the risk of splashing, additional measures (such as masks, goggles or face shields) are advised.
  • Dispose of urine or faeces to the drains via a toilet or sluice. Flush twice after use to ensure any I131 has been washed away.
  • Bag up any linen or waste contaminated with the patient’s blood, urine or faeces, label as “Radioactive – not for disposal” and store securely. Contact your local Nuclear Medicine department or Radiation Protection Adviser (RPA) for advice.
  • If possible, without adversely affecting the treatment of the patient, try to avoid prolonged close contact with the patient.
  • Pregnant staff should not have contact with the patient.

Patients requiring surgery/treatment

  • Seek advice from a Radiation Protection Adviser or Nuclear Medicine Physicist.
  • Non-urgent surgery should be delayed.
  • In the event that surgery cannot be delayed:
    • Do not allow pregnant staff in theatre.
    • Any clinical waste (including excised tissue) may be radioactive and cannot be disposed of via the normal route. Bag these materials separately, label as “Radioactive – not for disposal” and store securely until further advice is given by your local Nuclear Medicine department or Radiation Protection Adviser.
    • Specimens for pathology or other analysis may also be radioactive. Advise the laboratory that this is the case and ask the staff to retain the samples until advice can be sought from their local Nuclear Medicine department or Radiation Protection Adviser.
    • If it will not adversely impact on the surgery, the surgeon should wear two pairs of gloves which will give some protection against beta radiation.

Patients treated with I131 between 17 and 51 days ago

The only precautions required are regarding disposal of any items that may be contaminated with the patient’s bodily fluids or in the event of the death of the patient:

  • Any clinical waste (including excised tissue) may be radioactive and cannot be disposed of via the normal route. Bag these materials separately, label as “Radioactive – not for disposal” and store securely until further advice is given by your local Nuclear Medicine department or Radiation Protection Adviser.
  • Specimens for pathology or other analysis may also be radioactive. Advise the laboratory that this is the case and ask the staff to retain the samples until advice can be sought from their local Nuclear Medicine department or Radiation Protection Adviser.
  • Seek advice from the Radiation Protection Adviser before any post mortem or embalming.

Patients treated with I131 more than 51 days ago

No special precautions are required.

Hull University Teaching Hospitals Contacts:

Radiation Protection Adviser: 01482 461375

Nuclear Medicine Department: 01482 622125

Switchboard: 01482 875 875